The Standard

One of the most efficient ways to exchange data among providers and payers for prior authorization and other purposes is by taking advantage of standard application program interfaces (APIs) and a central hub to avoid manual processes and support of point-to-point interfaces.

The HL7^® Da Vinci Project’s new Trebuchet pilot program, launched earlier this year, is enabling additional pioneers to test that approach.

Trebuchet was created when Da Vinci members Regence, MultiCare Connected Care, and Blue Cross Blue Shield Arkansas sought ways to pilot Da Vinci use cases on the emerging TEFCA framework. They contacted multiple Qualified Health Information Networks™, or QHINs™, to gauge their interest in joining the pilot. eHealth Exchange joined the effort to perform the QHIN functions and provided valuable project management support.

The team named the coalition “Trebuchet” to illustrate how the success of a third-century military catapult could inspire providers, payers, and a QHIN to accelerate trusted and scalable exchange. 

As efforts advanced and participants increased, Trebuchet asked Da Vinci to take over project management. Now a priority project adopted by Da Vinci, Trebuchet is proving how eHealth Exchange’s nationwide trust model and “Networked FHIR” architecture rapidly deploy Smart-on-FHIR Prior Authorization and Clinical Data Exchange (CDex) at scale

Looking for an update on the HL7 Da Vinci Project’s accomplishments this year and the outlook for 2025? Then don’t miss a special year-end online session at 4 p.m. ET on December 11.

This meeting, which combines Da Vinci’s Member Forum and Operating Committee meetings and the December Community Roundtable, will review this year’s programmatic accomplishments and set the stage for 2025.

A Da Vinci leadership panel will discuss 2024 highlights, sharing progress across policy, use cases and implementer support. The panel will address the successful Fast Healthcare Interoperability Resources (FHIR®)) implementation outcomes listed in the HIPAA exception report as well as key partnerships and their interoperability journeys. (For more on the HIPAA exception report, see: Report on HIPAA Exception Project Describes Benefits of Using FHIR APIs).

Are you implementing Health Level Seven (HL7®) Fast Healthcare Interoperability Resources (FHIR®) APIs and looking for testing resources? Find out about the Inferno Health API Testing Framework at this month’s October HL7 Da Vinci Project Community Roundtable.

A report from the HL7 Da Vinci Project describes how two pioneering organizations demonstrated the real-world practicality and value of applying standard application program interfaces (APIs) to streamline the prior authorization process.

Regence, a payer based in the Pacific Northwest, and MultiCare Health System, a provider based in Washington state, spent about a year testing and fine-tuning processes that leverage HL7’s Fast Healthcare Interoperability Resources (FHIR^®) standard for APIs.

In addition, dozens of other organizations have tested FHIR APIs at more than 15 Connectathon testing events.

"Our response to interoperability isn’t just about managing data—it’s about building the future of healthcare through open standards." - Dan Vreeman, DPT, Chief Standards Development Officer, HL7 International

Last week at Civitas 2024 in Detroit, HL7 International/s Chief Standards Development Officer,Dan Vreeman, DPT, led an insightful panel session on how HL7® Fast Healthcare Interoperability Resources (FHIR®) is revolutionizing interoperability. As data sharing becomes increasingly critical, HL7 is at the forefront, driving collaboration with over 45 organizations and developing 35-45 new FHIR implementation guides annually! Dan was joined by leaders from the Da Vinci Project, FAST, Gravity Project, and Helios, to discuss their HL7 FHIR Accelerator projects, including objectives and progress made to date in advancing open data standards development and interoperability.

An Overview, Demo and Benefits of Da Vinci-related Test Kits on Wednesday, October 23

Are you implementing Health Level Seven (HL7®) Fast Healthcare Interoperability Resources (FHIR®) APIs and looking for testing resources? Find out about the Inferno Health API Testing Framework at this month’s October HL7 Da Vinci Project Community Roundtable.

This month’s session, Exploring Inferno: An Overview, Demo and Benefits of Da Vinci-related Test Kits, is scheduled for Wednesday, Oct. 23, from 4 – 5:30 PM EDT and features presenters from the Assistant Secretary for Technology Policy (ASTP) / Office of the National Coordinator for Health Information Technology (ONC) and MITRE. Presenters will introduce the Inferno Framework and voluntary test kits, which may be used as testing tools to further advance implementation guide development and testing of industry implementations.

August 28 Webinar Features Recent Updates Direct from Federal Officials

Are you looking for guidance and insight as you plan for 2025? If so, plan to attend this month’s Health Level Seven (HL7^®) Da Vinci Project Community Roundtable, which features special guests from the Assistant Secretary for Technology Policy (ASTP) office, formerly known as the Office of the National Coordinator for Health Information Technology (ONC). ASTP presenters will highlight why the Trusted Exchange Framework and Common Agreement^TM (TEFCA^TM) is important and share recent updates to the program, including implementation, long term plans, education and outreach, and building trust.

In ASTP’s second segment, testing and adoption efforts will be discussed, covering TEFCA’s HL7 Fast Healthcare Interoperability Resources (FHIR^®) Roadmap, and ASTP’s new TEFCA Payer/Provider 10x10 Coalition. ASTP will provide an overview of the 10x10 and discuss why providers and payers should participate. They will also discuss resources available and the interplay of the 10x10 with Da Vinci.  

The session concludes with the Da Vinci PMO sharing themes and perspectives from its membership on the Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2) proposed rule.

June 26discussion highlights efficiencies, burden reduction and features Blue Cross and Blue Shield Association, Providence and UC Davis Health  

This month’s roundtable focuses on the provider experience, as representatives from an academic health system and a seven-state comprehensive healthcare organization provide firsthand accounts regarding how clinicians and their teams are helping to lead the way with HL7 Da Vinci Project and HL7 Fast Healthcare Interoperability Resources (FHIR®) real-world production implementations of Da Vinci implementation guidesto enable interoperability and advance value-based care.  

Moderated by a representative of the Blue Cross and Blue Shield Association, the discussion unveils how payers’ and providers’ interactions evolve as they collaborate to tackle problems and address current pain points with the healthcare system. The panelists will share considerations, challenges and benefits of working together to establish infrastructure to streamline and automate prior authorization workflows, remove latency, and enable real-time data sharing, ultimately creating win-wins for patients, clinicians, administrators, payers and technologists. 

Industry invited to join and participate in the HL7 Da Vinci Project’s newest use case conference calls

Retrieving a duplicate of remittance advice that was previously issued by a payer is a headache-inducing manual process that can involve the use of web portals, phone calls, faxes and emails.

But implementing an HL7 Fast Healthcare Interoperability Resources (FHIR®) Application Programming Interface (API) could change all that.

The HL7 Da Vinci Project has launched a Postable Remittance Advice Use Case with the goal of publishing an implementation guide (IG) for such an API next year. The API will support the request for a duplicate copy of previously issued remittance advice – paper or electronic – in real time to allow efficient, timely and accurate posting of payments.

Remittance advice is a document that healthcare providers receive from insurance companies after submitting a claim. It provides information on the payment status of the claim, including the amount paid, the patient's responsibility and the reason for any denials or adjustments. The purpose of the remittance advice is to inform the healthcare provider of the remittance details and to allow them to reconcile their accounts and ensure that the payment is accurate.

May 29 Sessionfeatures athenahealth, Availity and Humana and honors HL7 Da Vinci Project Community Champions from 4:00 - 5:30 pm ET

Join us this month to hear real-world HL7 FHIR and Da Vinci implementation stories that will provide you with inspiration and insight into how you can apply the learnings of athenahealth, Availity and Humana to your organization’s efforts to reduce friction, increase efficiency and meet the federal interoperability rules. 

After recognizing the 2023 HL7 Da Vinci Project Community Champions, representatives of Availity and Humana will provide a current snapshot of Da Vinci’s effort to create a nationwide interoperable approach among payers using the Payer Data Exchange (PDex) Implementation Guide, which enables payers to create a member’s health history using clinical resources which can be understood by providers and electronic medical records (EMR) systems. This discussion provides an opportunity to better understand dynamics you’ll encounter in achieving payer-to-payer exchange compliance such as consent and endpoint discovery.  Attendees will gain a foundational understanding of the new regulatory requirements, learn about technical and business challenges and benefits from real-world implementers and gain insight into how industry is working together. 

April 24 Session Focuses on Importance of Testing and Connectathons for Implementation Success

In this timely overview, which allows you to prepare to participate in upcoming May, July and September Connectathons, the HL7 Da Vinci Projectwill highlight a key component of implementation: testing.

Experts and hands-on participants will outline why testing is important, the terms used in testing and how testing events, such as Connectathons, are organized and critical to implementation success. Who should be involved, the value of testing partnerships, what activities are planned, and how you can participate will also be discussed. The session concludes with an invaluable primer on testing tools and resources available for your use.

“Jumpstart Your HL7 FHIR Implementation: Testing and Connectathons Demystified,” is slated for April 24, 4 - 5:30 p.m. ET and features the following presenters:

• Jeff Brown, Healthcare Standards Advisor, Lantana Consulting Group
• Mike Gould, Associate Vice President, Interoperability Strategy, ZeOmega
• Kyle Johnsen, Software Developer, Epic

The session is moderated by Alix Goss, HL7 Da Vinci Project PMO, and Senior Consultant, Point-of-Care Partners.